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The White Noise

The White Noise

A hit of addiction and mental illness, chased by chemistry and culture.

Why a Heroin Vaccine Isn't a Fix-It

This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.

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Heroin addiction, a chronic relapsing disorder characterized by excessive drug taking and seeking, requires constant psychotherapeutic and pharmacotherapeutic interventions to minimize the potential for further abuse.

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The current study presents evidence of effective and continuous sequestration of brain-permeable constituents of heroin in the bloodstream following vaccination. The result is efficient blockade of heroin activity in treated rats, preventing various features of drugs of abuse: heroin reward, drug-induced reinstatement of drug seeking, and reescalation of compulsive heroin self-administration following abstinence in dependent rats.

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Thus, our vaccine represents a promising adjunct therapy for heroin addiction, providing continuous heroin antagonism, requiring minimal medical monitoring and patient compliance. ¹

In a house of drugs, there's not that much light. That might not surprise you. Electricity's stolen from next door, and next visit, there won't be any. For today, a hooded desk lamp sits in the doorway connecting the main room to a bedroom, and down the hall a door's a quarter of the way open, where light inside sends misshapen geometry onto the hallway's ceiling.

The people inside are pretty high, which might not surprise you either. But the woman propped on a milk crate in the corridor was raped at 12 and onwards for years after. The woman that exits the bedroom was continually sexually assaulted too, by a man that worked in her town diner's kitchen.

They're tough though. The women won't tell you about those memories for a while, and when they do, they won't remember later because they have to be high to carry the pain of the words. It's hard to be polite and maintain eye contact when recounting brutality aloud. It's hard to choose vulnerability when it's never helped. It's safer somehow to choose drugs, to forget.

Working Woman: Hunts Point, Bronx

Milk Crate, Hunts Point, Bronx. Courtesy of Chris Arnade.

The woman in the bedroom comes out for drugs, naturally. She's needed them in steady supply for years now, since 2007. First, heroin, to feel human, then crack for pleasure. Her Medicaid hasn't kicked in and she hasn't seen a real doctor in who-knows-when. She had bipolar medication once. She's tripled her heroin dosage in the last few weeks, now up to a bundle -- 10 bags -- a day. That's partially because she's felt like shit lately and partially because she's dealing drugs too, and the temptation's easily fulfilled.

She has a john in the bedroom, one who holds drugs in equal esteem to sex. Most of them do that. The girls are service providers of multiple things. He's already had his heroin, and now he wants his crack. They all want heroin once they've had it. No, not want. They need it. They're good self-treated patients. They know to take their medicine before their reward.

You notice that they keep their crack stem wrapped like cafeteria silverware in a napkin beneath the couch cushions and their heroin syringes and caps in a flat plastic baby wipes container. Crack and heroin bags are stowed in a clutch purse. One woman carries the purse around until she falls asleep, at which point one crack always disappears. After, the house denies taking it.

If you unzip the purse and take a crack out to rest it in your palm, you can barely feel it. If you close your eyes, it's as if there's nothing there. It feels the same later when you lay your hand open to bare air in your own quiet, well-lit apartment. Significant insignificance. The heroin in disarray at the bottom of the purse looks like pepper packets.

Crack Table: Hunts Point, Bronx

Crack table: Hunts Point, Bronx. Courtesy of Chris Arnade.

If you ask the women, they'll say they're heroin addicts, but crack's what they need to feel good. Of course they'll always do crack. Heroin's the problem, what gets them sick, why they want to go to rehab. Crack's fine -- it hardly counts.

A fist thuds against the door. The woman inside the bedroom shuffles in slippers to look through the peephole, then removes the fork acting as a doorjamb. Three men enter and look around. There are nearly a dozen people inside already. One says it isn't worth staying, that he has a job and can't get arrested again. A raid has to be coming in a place like this. He gestures to the open drugs and barely cogent people. He says it makes him nervous. Not worth it, the cops entering, knocking everyone to the floor, strip searching, hauling them to the precinct for the weekend. They leave.

People scream back and forth at one another across the apartment. Things about children, husbands, disrespect, court dates, promises. Someone yells at the others to stop screaming, that they're scaring away business.

A john comes out of the bedroom, sits next to you on the couch and rests a quarter-full brandy bottle against your leg. He looks at you, then looks away. The bottle was full when you walked in. He's had too much brandy to be able to speak. The women say he works in the neighborhood and comes for his drugs first on payday.

He gets up to wander back and forth in the main room, carrying a black backpack by a rubber handle. His boots with untied, kinked laces make him look like a child, but his roaming shirtless presence and stares remind you why he's there. He limply holds his bottle and a crumpled pack of Newport cigarettes.

The women forget him for a while until they spot him standing aimlessly and decide him to be a nuisance. "I told you to stay in the fucking bedroom, or to leave. Those are your choices. What are you doing?"

More women loll in the back of the house, nodding in a bed from heroin. From where they are, you can smell the trashcan where a woman dumped rotting rice and beans from the refrigerator. The nearby bathroom has no windows and no light but it does have a condom clogging the toilet. The sink doesn't work.

The group worries about losing the apartment, but only peripherally, because they live day by day.

When the yelling calms, the stories begin. One woman hasn't seen her man since he was locked up a few months ago. She asks you to check your phone to see where he is. You give her his court date. It's tomorrow. She wonders how she'll get to Criminal Court with no money. Her words are slow. She shot up in the middle of your conversation.

Another woman wants you to find a rehab that takes her insurance because she can't be here like this. Another wants you to find out about renter's rights for the apartment. They trade advice like gossip until they've all had a dope hit and slow down like battery-run toys. Crack, now.

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¹ Schlosburg, Joel E. "Dynamic Vaccine Blocks Relapse to Compulsive Intake of Heroin." PNAS.org. Proceedings of the National Academy of Sciences, 6 May 2013. Web. 26 May 2013.

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More Hunts Point Addiction Writing

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